Clinical investigations from the RACP

Investigating the patient with venous thromboembolic disease

Ian Prosser, Philip Crispin



The aims of investigation of patients with venous thromboembolic disease (VTE) are to identify occult predisposing conditions, estimate the probability of recurrence and direct further management.

Key Points

  • Venous thromboembolism (VTE) is multifactorial, with both congenital and acquired risk factors.
  • VTE may be the first presentation of systemic illness.
  • It is not necessary to investigate patients who have VTE following recent major surgery or other identified temporal risk factors.
  • Investigating for underlying systemic disease should be guided by careful history, examination and consideration of risk factors.
  • Identifying single gene defects, such as factor V Leiden, usually does not change management.
  • Specialist advice is suggested for multiple inherited defects or strongly thrombophilic defects, such as antithrombin deficiency.